Loss notification for Independent Adjusters – Part 1
Most independent insurance adjusting offices utilize some very common practices upon acceptance of an assignment. The adjusting firm is usually required to make contact with some combination of insured, claimant(s) and or witnesses, if any.
For your typical “common loss peril” such as hail or wind it’s generally acceptable to handle the loss acceptance via email and the loss notification to the insured with a phone call. It seems perfectly normal that this is the standard for most every adjusting firm, but what about larger losses? What is acceptable to the client and their insured? What provides for an adequate amount of protection without sparking the insured’s interest in retaining counsel or a public adjuster? 
Though it’s the insured’s every right to have counsel, it is no secret that attorneys and public adjusters drive the claim dollar “through the roof”, and more often than not out of the adjuster’s hands.
Let’s get one thing straight out of the box here: If you have been assigned a file with an expected loss of $50,000 in the property & casualty or liability fields, and aren’t working under a third party administrator then you need to consider writing a claim acknowledgement letter to the parties involved, for the protection of the insured, your client and your own self.
Part I in this series looks at the acknowledgment to the carrier and/or third party. I call this one “The Classic”:
Dear Mr. Claim Rep,
ABC Adjusting company acknowledges receipt of your claim number 55-A88-10 and will be contacting the insured to schedule our tentative appointment. Adjuster Smith has been assigned your file and his email is AdjusterSmith@domain.com. Please contact Mr. Smith if you have any questions related to the file and our further report will follow. Thank you for this assignment…
Sincerely,
Claim Scheduling
Independent-Adjuster.com
Here are some simple improvements and preventative procedures to consider when addressing a letter of acknowledgment to the claim carrier or third party representative who assigned the loss to you:
- Provide some moderate liability protection by addressing your letter from the viewpoint that a false bad faith suit is expected from your client; something I’ve never experienced but not unheard of. It’s imperative to address your impartiality and lack of bias in help relieve this pressure. This can be done by simply adding something along the lines of “our investigation will be made without bias of the parties involved and based only on the facts discovered“.
- Be sure to address the loss peril, loss address and named insured in your letter of acknowledgment. This prevents your liability on a multitude of levels prior to investigation and continues to hold as a valuable preventative so long as it’s addressed again in your formal report. It also shows your client that you read the loss notice carefully. Why would the address matter? Suppose you reviewed a loss by meeting the contractor while the insured were “out of town”. A few weeks later you’re talking to the insured because their contractor disappeared with some money and left them with an unfinished job. The next thing you know he had you looking at a different property next door and had switched the house numbers. There are all kinds of reasons!
- Reply back with a written copy of your police report request if one was solicited in the loss notice. Police report requests are all similar and easily filled out with the necessary file information, although some departments request using their own form that are often available online. This gives hard proof that you are already involved with work on the file but it primarily prevents the question of whether you “held your breath” on the file in the event someone gets anxious. A simple “claim in progress” notification won’t do you that well in a review. Be sure to consider a receipt from the police department or denial letter of unavailable because both documents will show the day you sent out your request, which should be within 24 hours of the time you received the file.
Address any and all concerns upfront and immediately. As an independent adjuster or any insurance claim professional you’ve got to make clear any immediate concerns you have about the file at the earliest possible time. Carrier claim reps, third party admins and self insureds can be in a hurry to deal with what might appear to be a simple loss. If they haven’t addressed a particular point that seems of concern, such as whether to take a witness’ recorded statement or obtain an affidavit then be sure to address it squarely. In-house counsel often has a set method they prefer to deal with these issues.
We’ll cover the letters to insured, witnesses and claim professionals on the other side in other postings to come.
Phillip Crimaldi has been employed as an insurance claim professional since 2003 and is currently employed as the Director of Operations at the Peak Claims Colorado office. Mr. Crimaldi oversees the company operations and manages daily file handling of super-load cargo losses, premises liability claims, residential property & casualty fires and subrogation investigations. Phillip contributes his expertise to Independent-Adjuster.com as often as possible and is frequently contacted by his colleagues for advice.
This article is subject to the Independent-Adjuster.com legal disclaimer. This article is not meant take the place of legal advice from an attorney.
